Characteristics of older patients undergoing surgery in the UK: SNAP-3, a snapshot observational study

IF 9.1 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia Pub Date : 2025-02-01 DOI:10.1016/j.bja.2024.11.024

Claire Jane Swarbrick , Karen Williams , Bob Evans , Helen Abigail Blake , Thomas Poulton , Samuel Nava , Akshay Shah , Peter Martin , Judith Stephanie Louise Partridge , Iain Keith Moppett , SNAP-3 collaborators

{"title":"Characteristics of older patients undergoing surgery in the UK: SNAP-3, a snapshot observational study","authors":"Claire Jane Swarbrick , Karen Williams , Bob Evans , Helen Abigail Blake , Thomas Poulton , Samuel Nava , Akshay Shah , Peter Martin , Judith Stephanie Louise Partridge , Iain Keith Moppett , SNAP-3 collaborators","doi":"10.1016/j.bja.2024.11.024","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Frailty and multimorbidity are common in older adults, but the prevalence and interaction of these conditions in surgical patients remain unclear. This study describes the clinical characteristics of a heterogeneous cohort of older UK surgical patients.</div></div><div><h3>Methods</h3><div>We conducted a prospective observational cohort study during 5 days in March 2022, aiming to recruit all UK patients aged 60 yr and older undergoing surgery, excluding minor procedures (e.g. cataract surgery). Data were collected on patient characteristics, clinical care, frailty, and multimorbidity measures.</div></div><div><h3>Results</h3><div>A total of 7134 patients from 214 NHS hospitals were recruited, with a mean (<span>sd</span>) age of 72.8 (8.1) yr. Of all operations, 69% (95% confidence interval [CI] 67.9–70.1%) were elective, and 34% (95% CI 32.7–34.8%) were day cases. Of the patients, 19% (95% CI 18.3–20.1%) were living with frailty (Clinical Frailty Score ≥5), and 63.1% (95% CI 62.0–64.3%) were living with multimorbidity (count of ≥2 comorbidities). Those living with frailty, multimorbidity, or both were typically older, were from lower socioeconomic backgrounds, and experienced greater polypharmacy and reduced independence. Patients living with frailty were less likely to undergo elective and day-case surgeries. Four out of five (78.8% [1079/1369]) of those who were living with frailty were also living with multimorbidity; 27.1% (1079/3978) of those who were living with multimorbidity were also living with frailty.</div></div><div><h3>Conclusions</h3><div>In the UK, one in five older patients undergoing surgery is living with frailty, and almost two-thirds of older patients are living with multimorbidity. These data highlight the importance of frailty screening. In addition, they can serve to guide resource allocation and provide comparative estimates for future research.</div></div>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 328-340"},"PeriodicalIF":9.1000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775840/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"British journal of anaesthesia","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0007091224007013","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Frailty and multimorbidity are common in older adults, but the prevalence and interaction of these conditions in surgical patients remain unclear. This study describes the clinical characteristics of a heterogeneous cohort of older UK surgical patients.

Methods

We conducted a prospective observational cohort study during 5 days in March 2022, aiming to recruit all UK patients aged 60 yr and older undergoing surgery, excluding minor procedures (e.g. cataract surgery). Data were collected on patient characteristics, clinical care, frailty, and multimorbidity measures.

Results

A total of 7134 patients from 214 NHS hospitals were recruited, with a mean (sd) age of 72.8 (8.1) yr. Of all operations, 69% (95% confidence interval [CI] 67.9–70.1%) were elective, and 34% (95% CI 32.7–34.8%) were day cases. Of the patients, 19% (95% CI 18.3–20.1%) were living with frailty (Clinical Frailty Score ≥5), and 63.1% (95% CI 62.0–64.3%) were living with multimorbidity (count of ≥2 comorbidities). Those living with frailty, multimorbidity, or both were typically older, were from lower socioeconomic backgrounds, and experienced greater polypharmacy and reduced independence. Patients living with frailty were less likely to undergo elective and day-case surgeries. Four out of five (78.8% [1079/1369]) of those who were living with frailty were also living with multimorbidity; 27.1% (1079/3978) of those who were living with multimorbidity were also living with frailty.

Conclusions

In the UK, one in five older patients undergoing surgery is living with frailty, and almost two-thirds of older patients are living with multimorbidity. These data highlight the importance of frailty screening. In addition, they can serve to guide resource allocation and provide comparative estimates for future research.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

British journal of anaesthesia 医学-麻醉学

CiteScore

13.50

自引率

7.10%

发文量

488

审稿时长

27 days

期刊介绍： The British Journal of Anaesthesia (BJA) is a prestigious publication that covers a wide range of topics in anaesthesia, critical care medicine, pain medicine, and perioperative medicine. It aims to disseminate high-impact original research, spanning fundamental, translational, and clinical sciences, as well as clinical practice, technology, education, and training. Additionally, the journal features review articles, notable case reports, correspondence, and special articles that appeal to a broader audience. The BJA is proudly associated with The Royal College of Anaesthetists, The College of Anaesthesiologists of Ireland, and The Hong Kong College of Anaesthesiologists. This partnership provides members of these esteemed institutions with access to not only the BJA but also its sister publication, BJA Education. It is essential to note that both journals maintain their editorial independence. Overall, the BJA offers a diverse and comprehensive platform for anaesthetists, critical care physicians, pain specialists, and perioperative medicine practitioners to contribute and stay updated with the latest advancements in their respective fields.